TITLE: Popular Opinion Leaders as a Sports Concussion Prevention Strategy in Middle Schools FOA: RFA-CE-17-002, Development and Evaluation of Sports Concussion Prevention Strategies PROJECT SUMMARY/ABSTRACT: Prevention of concussion is a key priority in the safety of young athletes participating in sport. Accordingly, a major focus over the past decade has been increasing the knowledge and awareness of concussion signs, symptoms, and management strategies. However, few studies have addressed primary and secondary prevention in the youth sport, particularly the middle school sport setting. Research is needed to develop and understand the most effective strategies for concussion prevention and management in this young population. Additionally, these strategies and interventions should be feasible and sustainable. We will address these research needs by developing and piloting a new intervention utilizing a Popular Opinion Leader (POL) model to prevent concussions in middle school sports. The study will include a diverse group of middle school sports teams from two school districts. Five youth sports with a high incidence of concussion and diverse participants (football, boys? soccer, girls? soccer, boys? basketball, and girls? basketball) will be studied. The project has three key aims. First, using formative methods, we will identify the institutional (Aim 1.1), team (Aim 1.2), peer (Aim 1.3) and personal (Aim 1.4) facilitators and barriers to adopting and implementing a POL concussion intervention in middle school football, basketball, and soccer sports communities. Second, we will determine the effect of a POL intervention on concussion-related behavioral and environmental determinants, including attitudes, beliefs, intentions, perceived control, and normative perceptions, among parents (Aim 2.1), coaches (Aim 2.2), and student-athletes (Aim 2.3) participating in middle school football, basketball, and soccer. Third, we will determine the effect of a POL intervention on concussion risk and clinical management, through decreased head impact frequency (Aim 3.1), increased reporting of suspected concussions (Aim 3.2), changes in concussion incidence (Aim 3.3), and improved management of confirmed concussions (Aim 3.4) among middle school student-athletes participating in football, basketball, and soccer. This study will significantly advance our scientific knowledge on the impact of a local concussion prevention programs on knowledge, attitudes, behaviors, and health outcomes in youth sports.